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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by femlite on January 15, 2004, at 10:59:44
One of the pdocs Ive been to, recomended Lithium and Adderall.
I have always been a litle afraid of Lithium.
And Im not sure Adderall is the right stim but my question is,
does this combo make sense to anyone? Could a stim work in combo with lithium?Im am likely BP II but it is becoming more clear Im also ADD.
In light of other med failures this combo is starting to intrigue me.
Any thoughts?
Posted by Keith Talent on January 15, 2004, at 11:31:41
In reply to Stimulants and LITHIUM ???, posted by femlite on January 15, 2004, at 10:59:44
The rationale might be that stimulants would be less likely to cause switching, but the combination would provide a synergistic antidepressant effect.
Posted by Maxime on January 15, 2004, at 15:03:38
In reply to Re: Stimulants and LITHIUM ???, posted by Keith Talent on January 15, 2004, at 11:31:41
Keith I am very interesting in your response because of the word "switching". I am hoping you mean from one mood to the next. You see, I am bipolar and thinking of trying ritalin as my anti-depressant but I worried that it might make me manic. Are you saying that it wouldn't?
Maxime
> The rationale might be that stimulants would be less likely to cause switching, but the combination would provide a synergistic antidepressant effect.
>
Posted by Laree on January 16, 2004, at 9:11:59
In reply to Stimulants and LITHIUM ???, posted by femlite on January 15, 2004, at 10:59:44
I have heard of diagnoses of ADHD/ADD & Bipolar getting confused before, ie: a pdoc may diagnose someone who's actually bipolar with adhd as many of the symptoms tend to mock each other in these disorders i guess. A while after my pdoc thought i had adhd, the assistant that worked for him began to suspect bipolar & had me keep a mood chart for about 2 weeks, but the results confirmed the adhd i suppose...? At any rate, he didn't think i was bipolar...
I am pretty sure I came across someone last year who was bipolar taking lithium & ritalin at the same time. A problem that may be anticipated with a stimulant is the affect it has when starts to wear off--it can make one feel a little sluggish and down, change your mood temporarily, etc...Adderall would probably be a better fit for someone w/Bp than Ritalin. The reasoning for this is that Adderall is said to have less harsh "drop-offs" (when it wears off toward the end of the day) than Ritalin. I really would not think a stim would be too great for someone w/bipolar as it can make one feel up/down in a relatively short amount of time (often within hours), but if it was an addition to a mood stabilizer then that may work out...I have never taken a mood stab. but it might be a good combo for bp? Best of luck to you!
--L.
Posted by Keith Talent on January 17, 2004, at 2:12:16
In reply to Re: Stimulants and LITHIUM ???}} Keith, posted by Maxime on January 15, 2004, at 15:03:38
> Keith I am very interesting in your response because of the word "switching". I am hoping you mean from one mood to the next. You see, I am bipolar and thinking of trying ritalin as my anti-depressant but I worried that it might make me manic. Are you saying that it wouldn't?
>
Maxime, by switching, I mean from either depressed mood or euthymia to hypomania/mania. I recall seeing a couple of papers in PubMed from the 1970s/early 80s that found that stimulants seemed to control mania. But I don't know that there's any evidence that they are less likely to cause switching in bipolar patients than antidepressants.
Posted by femlite on January 17, 2004, at 13:19:37
In reply to Re: Stimulants and LITHIUM ???}} Keith, posted by Keith Talent on January 17, 2004, at 2:12:16
After taking adderall, I had better motivtion and energy, but angry outbursts seems a real problem.
If Im BP it is the kind marked by irritability. Could be compounded by ADD i suppose.
I am trying provigil. After the first dose hit my bloodstream I felt a distinctive calming. But an hour or so later irritablity was still a problem.
Started Lithium 3 days ago. 300 am and pm.How long till blood levels are steady?
Im not looking forward to emotional blunting that I fear is inevatable. But I cant keep screaming at folks.
Posted by Interject79 on January 17, 2004, at 17:34:18
In reply to Stimulants and LITHIUM ???, posted by femlite on January 15, 2004, at 10:59:44
Lithium can offset stimulatory actions of Adderall. But without the stabiliser a bipolar individual could 'rapid cycle' with a stimulant. Bipolar disorder with ADD is a tough combination to treat. One consideration is that a very low dose of a mood stabiliser might not be too harsh on ADD if combined with a stimulant. Some of the atypical antipsychotics are used for mood stability. Perhaps one of those would work. Amisulpride and aripiprazole (Abilify) come to mind.
Best,
interject
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